The Radiopaedia Reading Room Podcast 67. Musculoskeletal infection MRI nomenclature with Erin Alaia
Jul 15, 2025
Erin Alaia, an Associate Professor of Radiology and Orthopaedic Surgery at NYU Langone Health, joins radiologist Matt Skalski to discuss the updated MRI nomenclature for musculoskeletal infections. They explore fascinating terms like the penumbra sign and the nuances between conditions such as osteitis and osteomyelitis. The conversation takes a humorous turn with debates on Lyme disease misunderstandings and lighthearted anecdotes about the quirks of report formatting. Expect laughter, learning, and insightful anecdotes on the world of radiology!
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Avoid 'Reactive Osteitis' Term
- Avoid using the term 'reactive osteitis' as it is misleading in infection contexts.
- Do not comment on abscess drainability in reports; leave that to clinicians for clinical decisions.
Differentiating Osteomyelitis vs Charcot
- Osteomyelitis diagnosis hinges on matching confluent low T1 signal and fluid-sensitive marrow changes deep to ulcers.
- Charcot arthropathy marrow changes are periarticular and often lack confluent low T1 signal, aiding differentiation.
Contrast Essential for Cellulitis
- Use intravenous contrast to confidently diagnose cellulitis, differentiating it from bland edema.
- Look for focal, unilateral soft tissue thickening and adjacent skin changes with clinical signs for cellulitis.